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Treatment of S aureus experimental osteomyelitis with Matrix III delivered amikacin or clindamycin



Treatment of S aureus experimental osteomyelitis with Matrix III delivered amikacin or clindamycin



Abstracts of the Interscience Conference on Antimicrobial Agents & Chemotherapy 41: 59



Backround: Matrix III is a novel biodegradable polymer (Royer Biomedical) developed for orthopedic surgical dead space management and local antimicrobial delivery in osteomyelitis. We studied Matrix III beads loaded with amikacin or clindamycin for treatment of methicillin-susceptible S. aureus (MSSA) experimental osteomyelitis. The MSSA used in vivo had an amikacin MIC of 4 mug/mL and a clindamycin MIC of 0.25 mug/mL. Methods: Experimental osteomyelitis was established in Wistar rats by inoculating a sclerosing agent and 8X106 cfu of MSSA into the medullary cavity of the proximal left tibia. Treatment was initiated four weeks after infecting the rats. Treatment consisted of debridement of the infection site and placement of a single 3 mm plain Matrix III bead, a Matrix III bead containing 10% amikacin, or a Matrix III bead containing 10% clindamycin into the infection site. After 21 days treatment, rats were sacrificed; the tibiae were aseptically removed and cultured quantitatively. MSSA recovered from tissues were screened for emergence resistance to amikacin or clindamycin. The results of treatment were expressed as log10 colony forming units of MSSA per gram of tissue and analyzed by rank sum analysis. Conclusion: Treatment with clindamycin incorporated into a Matrix III bead was significantly more efficacious (P<0.05) than treatment with plain Matrix III. Further studies of the efficacy of Matrix III delivered antimicrobials are warranted.

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